Monday, November 9, 2009

Mrs. Freek, I'm so glad Cymbalta at 60mg each day has helped your symptoms.

I'm sorry I don't seem very sympathetic in refusing to write a letter to your insurance company about the drug. Honestly, this stuff ain't cheap, and you should appreciate that your company is willing to cover it for you at all.

The 30mg and 60mg pills cost about the same per pill. So taking two of the 30mg each night, instead of one 60mg, basically doubles the price. And I really don't have a good reason to tell your insurance that they should pay the higher cost.

There might be medical reasons SOME people need this, but "because I like the cute blue & white 30mg, and not the ugly blue & green 60mg" is not one of them.

I also appreciate that blue & white are the colors of your alma mater, but again, I don't think your insurance company is going to feel that justifies them paying twice as much for your pills.

I used to have patients refuse meds (back when I worked retail) because the generic wasn't the same color it used to be. They would absolutely refuse to take a little blue pill, because they were convinced that blue was a much less effective color than white.

I'm slightly confused (perhaps I need a consult, Grumps?)...you are a neurologist...I get it...you deal with the brain and nerves...isn't Cymbalta an antidepressant? I mean...I guess I get it, but it still confuses me...don't you deal more with the physical aspects of the brain, or am I not fully understanding neurology? If you guys deal with the other aspects of the brain, why do we need Psychiatrists?

Cymbalta is also used for diabetic nerve pain, and other chronic pain syndromes.

And all neurologists, whether we like it or not, end up doing some psychiatry. Patients with neurological disease are often depressed or anxious, and realistically very few psychiatrists take insurance anymore. So somebody has to treat them.

I have an idea - "colour your own" packs from the drug companies! I can see it now, little groups getting together for little "pill painting parties". May take over from quilting and scrapbooking!

Of course, there would be the problem with drug identification if all pills were white, but hey, what's a little safety & inconvenience to your Dr or Nurse when you could have your presription meds match your outfit, your cat's outfit, the car, the curtains, your alma mater... the possibilities are endless :)

Ah...it all makes so much sense...I didn't even think of diabetic neuropathy...and the insurance thing...totally get it...even understand the pain/depression thing...just surprised me a little. Thanks for explaining, Grumps :)

Now, could you do something to get my Zoloft in plaid or with polka dots? :D

One of my first jobs as an intern at Osco Drugs was to dump out a brown stock bottle of Lilly's Prozac, and picking all the capsules that had Lilly written on them as they were mixed in with those that were imprinted with Lilly's generic company brand imprinted. The patient supposedly felt a lot better taking the ones marked Lilly than the other made on the same lab bench, so to speak, may've been more closer to the window there and thus a more 'sunshiny' dose. Perhaps, Sarafem made Lilly a lot more money as Sarafem than generic Prozac, or at least 'some' money as a brand-name drug, since generic fluoxetine is on Wal-mart's 4$ list.

Welcome to my whining!

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